[The right ventricle in heart diseases].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to A Branzi.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We studied the pattern of inheritance of hypertrophic cardiomyopathy among 111 first-degree relatives of 30 patients with the disease. Results of segregation analysis suggest a genetic heterogeneity for hypertrophic cardiomyopathy in that both autosomal dominant and autosomal recessive mode of inheritance can occur.
Explore the source record for details and available documents.
The detection of myocardial depression is an important goal in the management of patients with chronic severe aortic regurgitation but may be quite difficult at an early stage by the conventional basal measures of contractility. The response to afterload stress determined by angiotensin challenge and the end-systolic pressure-volume relationship was evaluated echocardiographically in 16 asymptomatic or mildly symptomatic patients with chronic severe aortic regurgitation, ages 15 to 56 years (mean 32 +/- 12). Nine normal subjects, ages 25 to 41 years (mean 31 +/- 5), served as a control group. In the group with aortic regurgitation, end-systolic dimensions were greater than 55 mm in five of 16 patients and fractional shortening was 25% or less in two of 16. In the control group angiotensin caused a decrease of stroke volume index in six out of nine patients (15% at the most) and a mild increase in three. In the group with aortic regurgitation stroke volume index decreased by 15% or more of the basal value in nine of 16 patients and increased or decreased by less than 15% in seven of 16. Ejection fraction decreased in both groups, from 61 +/- 6% to 52 +/- 7% in the control group and from 56 +/- 6% to 45 +/- 5% in the group with aortic regurgitation. Ventricular function curves were derived by relating end-diastolic volume index to stroke work index; seven of 16 patients had abnormal responses reflecting an afterload mismatch.(ABSTRACT TRUNCATED AT 250 WORDS)
The hemodynamic effects of an acute infusion of prenalterol (PN), a new inotropic beta-adrenoceptor agonist, have been evaluated by cardiac catheterization in 10 patients with primary dilated (congestive) cardiomyopathy. A single dose of 20 micrograms/kg was administered over 5 min after basal hemodynamic and angiographic measurements. The administration of prenalterol caused a significant increase in mean cardiac index, from 2.3 to 3.3 l/min/m2 (P less than 0.01) and mean stroke volume, from 47 to 62 ml (P less than 0.01) without a change in heart rate. Mean left ventricular end-diastolic pressure was reduced from 19 to 13 mm Hg (P less than 0.05) and left ventricular dp/dt rose from 902 to 1089 mm Hg/s (P less than 0.01). Stroke work index increased from 27 to 40 g m/m2 (P less than 0.01) and ejection fraction from 31 to 36% (P less than 0.05). Mean blood pressure did not change and the systemic vascular resistance decreased from 24 to 17 RU (P less than 0.01). The favorable effect of prenalterol on left ventricular relaxation was shown by an increase of peak negative left ventricular dp/dt from 946 to 1159 mm Hg/s and by a decrease of the time constant of left ventricular pressure fall from 49 to 39 s. These results demonstrated a positive inotropic effect of prenalterol on patients with diffuse and severely reduced contractility.
We report the case of a women, 40 years old, suffering from a severe mitral insufficiency caused by the simultaneous presence of three anatomical anomalies: mitral valve prolapse, mitral anulus dilation and calcification. Such degrees of calcification are generally found in older people and in association with a similar degeneration of all the fibrous skeleton of the heart. Whereas the association of mitral valve prolapse with mitral anulus dilation has been clearly remarked, a few cases (16 as a whole in our knowledge) with scanty details documented the possibility of an associated mitral anulus calcification.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Volume angiography is a widely diffused technique in hemodynamic laboratories despite several factors which limit the validity of the method. We have evaluated three of these factors: a) indefiniteness in the identification of the contour of the left ventricular cavity on the projected image; b) indefiniteness due to the reproducibility in tracing the contour of the left ventricular cavity by the same operator; c) indefiniteness related to the geometrical assumption (ellipsoid of revolution). The indefiniteness, given as per cent variation from the mean value, has been determined for the diastolic as well as systolic phase. The maximal possible indefiniteness, for diastole and systole, in contours identification in 15 cases has been found to be +/- 11.3% and +/- 24% of the mean volume. Intra observer reproducibility evaluated outlining 30 times the left ventricular contour has been equal to a mean difference from the mean volume of +/- 1.2% for diastole and +/- 4% for systole. The mean difference of the mean volume calculated with the area-lenght method (ellipsoid geometry) from the volume calculated with the Simpson rule has been, on 15 cases, equal to 4% in diastole and 11% in systole. This high level of indefiniteness, mainly for the systolic phase, must be considered before giving a value excessively precise to the volume data obtained with angiography. On the other hand, the method retains an orientative meaning extremely useful in clinical evaluation.
Explore the source record for details and available documents.
Hemodynamic effects of two antiarrhythmic agents, disopyramide and procainamide, have been evaluated in anesthetized open-chest healthy pigs after random administration. At therapeutic plasma concentrations none of these agents proved to have deleterious hemodynamic effects. The most important action was observed after disopyramide infusion and consisted in significant bradycardia which confirmed the known effect on sinus node automaticity of the drug. Left ventricular dp/dt, an index of cardiac contractility, was unchanged after infusion of both drugs. On the ECG intervals, only procainamide provoked a significant prolongation of QTc. It is concluded that at therapeutic dosage disopyramide does not present deleterious hemodynamic effects in animals and proves to be a valid alternative to other traditional antiarrhythmic agents.
The haemodynamic effects of the infusion of dobutamine in dosages of 2-5, 5-0 and 10-0 mug/kg/min were studied in twelve patients with coronary artery disease. At the lowest dose, infusion of dobutamine caused a significant increase in cardiac output; greater increases occurred with doses of 5-0 and 10-0 mug/kg/min. The means by which the myocardium produced the increase in cardiac output differed according to the dose of the drug; 2-5 and 5-0 mug/kg/min produced an increase in stroke volume without any significant variation in the heart rate. At the highest dose rate, an increase in heart rate made a distinct contribution to the overall increase in output. The ventricular dp/dt max. increased at all three dosages. Blood pressure, pulmonary arterial and capillary pressure, and left ventricular and diastolic pressure did not show any significant change. The separation of the inotropic and the chronotropic effects of dobutamine according to the infused dose appears to have extremely interesting clinical implications.